§ 249A.1 Title
§ 249A.2 Definitions
§ 249A.3 Eligibility
§ 249A.3A Medical assistance — all income-eligible children
§ 249A.4 Duties of director
§ 249A.4B Medical assistance advisory council
§ 249A.5 Recovery of payment
§ 249A.6 Assignment — lien
§ 249A.6A Restitution
§ 249A.7 Fraudulent practices — investigations and audits — Medicaid fraud fund
§ 249A.8 Fraudulent practice
§ 249A.11 Payment for patient care segregated
§ 249A.12 Assistance to persons with an intellectual disability
§ 249A.13 Medicaid managed care organization premiums fund
§ 249A.15 Licensed psychologists eligible for payment — provisional licensees
§ 249A.15A Licensed marital and family therapists, licensed master social workers, licensed mental health counselors, certified alcohol and drug counselors, licensed behavior analysts, and licensed assistant behavior analysts — temporary licensees
§ 249A.15B Speech pathologists eligible for payment
§ 249A.16 New rates for services — effective date
§ 249A.18 Cost-based reimbursement — rural health clinics and federally qualified health centers
§ 249A.18A Resident assessment
§ 249A.20 Noninstitutional health providers — reimbursement
§ 249A.20A Preferred drug list program
§ 249A.21 Intermediate care facilities for persons with an intellectual disability — assessment
§ 249A.24 Iowa medical assistance drug utilization review commission — created
§ 249A.26 State and county participation in funding for services to persons with disabilities — case management
§ 249A.27 Indemnity for case management and disallowed costs
§ 249A.28 Hospital directed payment — prohibition of pass-through on non-Medicaid payors
§ 249A.29 Home and community-based services waiver providers — records checks
§ 249A.30 Home and community-based services waiver — service provider reimbursement rate adjustments
§ 249A.30A Medical assistance — personal needs allowance
§ 249A.31 Reimbursement — targeted case management services — inpatient psychiatric services
§ 249A.32 Medical assistance home and community-based services waivers — consumer-directed attendant care — termination of contract
§ 249A.32A Home and community-based services waivers — limitations
§ 249A.32B Early and periodic screening, diagnosis, and treatment funding
§ 249A.33 Pharmaceutical settlement account — medical assistance program
§ 249A.35 Purchase of qualified long-term care insurance policy — computation under medical assistance program
§ 249A.37 Duties of third parties
§ 249A.38 Inmates of public institutions — suspension of medical assistance
§ 249A.39 Reporting of overpayment
§ 249A.40 Involuntarily dissolved providers — overpayments or incorrect payments
§ 249A.41 Overpayment — interest
§ 249A.42 Overpayment — limitations periods
§ 249A.42A Overpayment — subsequent ineligibility of recipient — recovery — recoupment — reimbursement
§ 249A.43 Provider overpayment — notice — judgment
§ 249A.44 Overpayment — emergency relief
§ 249A.45 Provider’s third-party submissions
§ 249A.46 Liability of other persons — repayment of claims
§ 249A.47 Improperly filed claims — other violations — imposition of monetary recovery and sanctions
§ 249A.48 Temporary moratoria
§ 249A.49 Internet site — providers found in violation of medical assistance program
§ 249A.50 Fraudulent practices — investigations and audits — Medicaid fraud fund
§ 249A.51 Fraudulent practice
§ 249A.52 Garnishment
§ 249A.53 Recovery of payment
§ 249A.54 Responsibility for payment on behalf of Medicaid-eligible persons — liability of other parties
§ 249A.55 Restitution
§ 249A.56 County attorney to enforce
§ 249A.57 Health care facilities — penalty
§ 249A.58 Cooperation with child support services

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Terms Used In Iowa Code > Chapter 249A - Medical Assistance

  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Child: includes but shall not be limited to a stepchild, foster child, or legally adopted child and means a child actually or apparently under eighteen years of age, and a dependent person eighteen years of age or over who is unable to maintain the person's self and is likely to become a public charge. See Iowa Code 252A.2
  • clerk: means clerk of the court in which the action or proceeding is brought or is pending; and the words "clerk's office" mean the office of that clerk. See Iowa Code 4.1
  • Committee membership: Legislators are assigned to specific committees by their party. Seniority, regional balance, and political philosophy are the most prominent factors in the committee assignment process.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Consumer: means any one of the following:
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Counterclaim: A claim that a defendant makes against a plaintiff.
  • Court: shall mean and include any court upon which jurisdiction has been conferred to determine the liability of persons for the support of dependents. See Iowa Code 252A.2
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Department: means the department of health and human services. See Iowa Code 249A.2
  • Department: means the department of health and human services. See Iowa Code 249L.2
  • Dependent: A person dependent for support upon another.
  • Dependent: shall mean and include a spouse, child, mother, father, grandparent, or grandchild who is in need of and entitled to support from a person who is declared to be legally liable for such support. See Iowa Code 252A.2
  • Director: means the director of health and human services. See Iowa Code 249A.2
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Discretionary medical assistance: means mandatory medical assistance or optional medical assistance provided to medically needy individuals whose income and resources are in excess of eligibility limitations but are insufficient to meet all of the costs of necessary medical care and services, provided that if the assistance includes services in institutions for mental diseases or intermediate care facilities for persons with an intellectual disability, or both, for any group of such individuals, the assistance also includes for all covered groups of such individuals at least the care and services enumerated in Tit. See Iowa Code 249A.2
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • executor: includes administrator, and the term "administrator" includes executor, where the subject matter justifies such use. See Iowa Code 4.1
  • Executor: A male person named in a will to carry out the decedent
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Family investment program: means the family investment program eligibility requirements under chapter 239B, except to the extent federal law requires application of the eligibility requirements under Iowa Code 249A.2
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • Fraud: Intentional deception resulting in injury to another.
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Institution: means a birthing hospital. See Iowa Code 252A.2
  • Intellectual disability: means a diagnosis of intellectual disability or intellectual developmental disorder, global developmental delay, or unspecified intellectual disability or intellectual developmental disorder which diagnosis shall be made only when the onset of the person's condition was during the developmental period and based on an assessment of the person's intellectual functioning and level of adaptive skills. See Iowa Code 4.1
  • Internet: means the federated international system that is composed of allied electronic communication networks linked by telecommunication channels, that uses standardized protocols, and that facilitates electronic communication services, including but not limited to use of the world wide web; the transmission of electronic mail or messages; the transfer of files and data or other electronic information; and the transmission of voice, image, and video. See Iowa Code 4.1
  • Internet site: means a specific location on the internet that is determined by internet protocol numbers, by a domain name, or by both, including but not limited to domain names that use the designations ". See Iowa Code 4.1
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Life estate: A property interest limited in duration to the life of the individual holding the interest (life tenant).
  • Majority leader: see Floor Leaders
  • Mandatory medical assistance: means payment of all or part of the costs of the care and services required to be provided by Tit. See Iowa Code 249A.2
  • Manufacturer: means a person who manufactures or assembles assistive devices and agents of that person, including an importer, a distributor, a factory branch, distributor branch, and any warrantors of the assistive device, but does not include an assistive device dealer or assistive device lessor. See Iowa Code 216E.1
  • Medicaid: means payment of all or part of the costs of the care and services made in accordance with Tit. See Iowa Code 249A.2
  • Medicaid program: means the program established under this chapter to provide medical assistance. See Iowa Code 249A.2
  • Minority leader: See Floor Leaders
  • month: means a calendar month, and the word "year" and the abbreviation "A. See Iowa Code 4.1
  • Nursing facility: means a licensed nursing facility as defined in section 135C. See Iowa Code 249L.2
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Optional medical assistance: means payment of all or part of the costs of any or all of the care and services authorized to be provided by Tit. See Iowa Code 249A.2
  • overpayment: includes such funds for which the provider's administrative and judicial review remedies under Iowa Code 249A.2
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Party: means a petitioner, a respondent, or a person who intervenes in a proceeding instituted under this chapter. See Iowa Code 252A.2
  • person: means individual, corporation, limited liability company, government or governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity. See Iowa Code 4.1
  • persons with mental illness: include persons with psychosis, persons who are severely depressed, and persons with any type of mental disease or mental disorder, except that mental illness does not refer to intellectual disability, or to insanity, diminished responsibility, or mental incompetency as defined and used in the Iowa criminal code or in the rules of criminal procedure, Iowa court rules. See Iowa Code 4.1
  • Petitioner: includes each dependent person for whom support is sought in a proceeding instituted pursuant to this chapter or a mother or putative father of a dependent. See Iowa Code 252A.2
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Probate: Proving a will
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • property: includes personal and real property. See Iowa Code 4.1
  • Provider: means an individual, firm, corporation, association, or institution which is providing or has been approved to provide medical assistance to recipients under this chapter. See Iowa Code 249A.2
  • Recipient: means a person who receives medical assistance under this chapter. See Iowa Code 249A.2
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Rule: includes "regulation". See Iowa Code 4.1
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • state: when applied to the different parts of the United States, includes the District of Columbia and the territories, and the words "United States" may include the said district and territories. See Iowa Code 4.1
  • Statute: A law passed by a legislature.
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
  • Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. Source: OCC
  • United States: includes all the states. See Iowa Code 4.1
  • Venue: The geographical location in which a case is tried.
  • year: means twelve consecutive months. See Iowa Code 4.1